Provider Demographics
NPI:1144216706
Name:MILLER, ARTHUR LLOYD (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:LLOYD
Last Name:MILLER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 S CHICAGO
Mailing Address - Street 2:336 TRSS/SGF USAF SERE SCHOOL
Mailing Address - City:FAIRCHILD AFB
Mailing Address - State:WA
Mailing Address - Zip Code:99011
Mailing Address - Country:US
Mailing Address - Phone:509-247-3899
Mailing Address - Fax:509-247-3543
Practice Address - Street 1:2504 S. CHICAGO
Practice Address - Street 2:336 TRSS/SGF USAF SERE SCHOOL
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:99011
Practice Address - Country:US
Practice Address - Phone:509-240-3899
Practice Address - Fax:509-247-3543
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1348103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1348OtherPSYCHOLOGY LICENSE